Healthcare Provider and Payer Markets

After a brief discussion of the evolution of competition in healthcare markets, we review key economic concepts and empirical research, addressing in turn the three largest sectors of the healthcare industry: hospitals, physicians, and insurers. For each sector, we present illustrative, often seminal, antitrust cases, while emphasizing the interaction between economic research and litigation outcomes in antitrust cases. With respect to providers, we address issues that arise in horizontal mergers and then turn attention to common categories of vertical theories of harm, largely pertaining to exclusionary conduct. With respect to payers, we separately examine competition in output markets (the sale of commercial health insurance) and input markets (the purchase of provider services) and show how the two are intertwined. We conclude with a discussion of the role of competition policy in the midst of rapidly evolving public and private healthcare reform initiatives.